SACRAMENTO – Insurance Commissioner Dave Jones today announced that the Office of Administrative Law (OAL) approved the emergency regulations aimed at eliminating delays and denials of coverage for autism treatment. Commissioner Jones issued these emergency regulations to protect children diagnosed with autism and their families from the emotional, physical and financial harms caused by insurer denials or significant delays in autism treatment, which has reached crisis proportions in California.

“I am extremely pleased that the Office of Administrative Law has approved our emergency regulations,” said Commissioner Jones. “These emergency regulations will ensure that insurance companies cover medically necessary treatment required by the Mental Health Parity Act and Senator Darrell Steinberg’s autism treatment legislation. Autistic children and their families should now, without delay, receive the transformative treatment that will enable them to succeed in school, their families, and communities.”

The California Mental Health Parity Act was intended to provide adequate private health insurance coverage and benefits for mental illnesses. The legislature found that autism is one of several severe mental conditions that are seriously disabling. Failure to provide adequate coverage in private health insurance policies significantly increases expenditures by state and local government for medical treatment, special education and other services.

Later laws, such as SB 946 (Steinberg), signed by Governor Jerry Brown in October, 2011, reconfirmed the mandate for health insurers and HMOs to provide behavioral health treatment for autism. This emergency regulation is expected to benefit thousands of California’s children and families and save California taxpayers approximately $138.8 million to $197.8 million over the next year in costs that should properly be borne by insurers. These emergency regulations are the latest in a series of actions taken by Commissioner Jones to make sure autistic children can receive behavioral therapy treatment.

IN THE WAKE OF SANDY HOOK , WE SAY MANY THANKS TO AP SENIOR VP AND EDITOR KATHLEEN CARROLL.

On March 7, 2013 the Associated Press added an entry on mental illness to the AP Stylebook.

“It is the right time to address how journalists handle questions of mental illness in coverage,” said AP Senior Vice President and Executive Editor Kathleen Carroll. “This isn’t only a question of which words one uses to describe a person’s illness. There are important journalistic questions, too.

“When is such information relevant to a story? Who is an authoritative source for a person’s illness, diagnosis and treatment? These are very delicate issues and this Stylebook entry is intended to help journalists work through them thoughtfully, accurately and fairly.”

Mental Illness Do not describe an individual as mentally ill unless it is clearly pertinent to a story and the diagnosis is properly sourced. When used, identify the source for the diagnosis. Seek firsthand knowledge; ask how the source knows. Don’t rely on hearsay or speculate on a diagnosis. Specify the time frame for the diagnosis and ask about treatment. A person’s condition can change over time, so a diagnosis of mental illness might not apply anymore. Avoid anonymous sources. On-the-record sources can be family members, mental health professionals, medical authorities, law enforcement officials and court records. Be sure they have accurate information to make the diagnosis. Provide examples of symptoms.

Mental illness is a general condition. Specific disorders are types of mental illness and should be used whenever possible: He was diagnosed with schizophrenia, according to court documents. She was diagnosed with anorexia, according to her parents. He was treated for depression.

Some common mental disorders, according to the National Institute of Mental Health (mental illnesses or disorders are lowercase, except when known by the name of a person, such as Asperger’s syndrome):

– Autism spectrum disorders. These include Asperger’s syndrome, a mild form of autism. Many experts consider autism a developmental disorder, not a mental illness.

– Bipolar disorder (manic-depressive illness)

– Depression

– Obsessive-compulsive disorder (OCD)

– Post-traumatic stress disorder (PTSD)

– Schizophrenia

Here is a link from the National Institute of Mental Health that can be used as a reference:

Do not use derogatory terms, such as insane, crazy/crazed, nuts or deranged, unless they are part of a quotation that is essential to the story. Do not assume that mental illness is a factor in a violent crime, and verify statements to that effect. A past history of mental illness is not necessarily a reliable indicator. Studies have shown that the vast majority of people with mental illness are not violent, and experts say most people who are violent do not suffer from mental illness.

Avoid unsubstantiated statements by witnesses or first responders attributing violence to mental illness. A first responder often is quoted as saying, without direct knowledge, that a crime was committed by a person with a “history of mental illness.” Such comments should always be attributed to someone who has knowledge of the person’s history and can authoritatively speak to its relevance to the incident. Avoid descriptions that connote pity, such as afflicted with, suffers from or victim of. Rather, he has obsessive-compulsive disorder.

Double-check specific symptoms and diagnoses. Avoid interpreting behavior common to many people as symptoms of mental illness. Sadness, anger, exuberance and the occasional desire to be alone are normal emotions experienced by people who have mental illness as well as those who don’t.

About AP

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People have been arguing about autism for a long time—about what causes it, how to treat it and whether it qualifies as a mental disorder. The controversial idea that childhood vaccines trigger autism also persists, despite the fact that study after study has failed to find any evidence of such a link. Now, psychiatrists and members of the autistic community are embroiled in a more legitimate kerfuffle that centers on the definition of autism and how clinicians diagnose the disorder. The debate is not pointless semantics. In many cases, the type and number of symptoms clinicians look for when diagnosing autism determines how easy or difficult it is for autistic people to access medical, social and educational services.

The controversy remains front and center because the American Psychiatric Association (APA) has almost finished redefining autism, along with all other mental disorders, in an overhaul of a hefty tome dubbed the Diagnostic and Statistical Manual of Mental Disorders (DSM)—the essential reference guide that clinicians use when evaluating their patients. The newest edition of the manual, the DSM-5, is slated for publication in May 2013. Psychiatrists and parents have voiced concerns that the new definition of autism in the DSM-5 will exclude many people from both a diagnosis and state services that depend on a diagnosis.

The devilish confusion is in the details. When the APA publishes the DSM-5, people who have already met the criteria for autism in the current DSM-IV will not suddenly lose their current diagnosis as some parents have feared, nor will they lose state services. But several studies recently published in child psychiatry journals suggest that it will be more difficult for new generations of high-functioning autistic people to receive a diagnosis because the DSM-5 criteria are too strict. Together, the studies conclude that the major changes to the definition of autism in the DSM-5 are well grounded in research and that the new criteria are more accurate than the current DSM-IV criteria. But in its efforts to make diagnosis more accurate, the APA may have raised the bar for autism a little too high, neglecting autistic people whose symptoms are not as severe as others. The studies also point out, however, that minor tweaks to the DSM-5 criteria would make a big difference, bringing autistic people with milder symptoms or sets of symptoms that differ from classic autism back into the spectrum

The CDC announced on March 29, 2012 that the autism prevalence in the United States increased to 1 in 88 children and (1 in 54 boys and 1 in 252 girls). More children are affected by autism than diabetes, AIDs, cancer, cerebral palsy, cystic fibrosis, muscular dystrophy or Down syndrome combined. This stark increase warrants immediate assistance and solutions.

Many experts contribute the increase in the prevalence of autism to improved diagnostic tools, however, it is important to not overlook other factors and studies which indicate environmental, and non-genetic influences which suggests improved detection is not the overwhelming result of the pervasiveness of autism.

To assist with implementation of Senate Bill 946 and to address other issues, the state of California is convening an Autism Advisory Task Force to begin work on February 1. Among other duties, the task force will review evidence-based interventions and determine the necessary qualifications, training, and supervision of providers.

The American Occupational Therapy Association (AOTA) and the Occupational Therapy Association of California (OTAC) nominated AOTA President Florence Clark, PhD, OTR/L, FAOTA, to the task force, and the nomination was accepted.

“Dr. Clark is the ideal occupational therapy representative for the Autism Advisory Task Force with her wealth of clinical, research, and advocacy experience serving children with autism spectrum disorders,” says OTAC President Shawn Phipps, PhD, OTR/L, FAOTA. Clark’s participation on the task force allows occupational therapy to have a strong voice in discussions that will determine effective interventions for children with autism.

Gov. Brown wants the task force to determine the effectiveness of treatments and the appropriate duration and cost. The task force will meet monthly until the end of 2012 and submit a report to the governor of their findings and recommendations.

Some critics of the new law, many in the health insurance industry, say that the price of covering the interventions will raise the cost of health insurance premiums. Let us know what you think!

In October of 2011, Governor Brown signed Senate Bill 946 into law. This law requires that intensive outpatient behavioral health services be provided for people with autistic spectrum disorders. This law will go into effect July 1, 2012 for all CA state regulated plans.

For more details on the SB946 and your childs medical insurance coverage see the link below:

GF/CF diets are under attack once again, recent studies have attempted to pick apart the benefits of special diets for children on the autism spectrum. (http://holykaw.alltop.com/autism-not-alleviated-by-restricted-diet) Contrary to these studies parents continue to report significant improvements in their child’s cognition, behavior and response to the environment. Unfortunately, I am not at all convinced by this study! There’s significant research and parent testimony which disputes the findings in this case. As a parent of a child with autism I am convinced that children on the autism spectrum benefit from having a restrictive diet! In our experience, not only was gluten, and casein major allergins; sugar, sodium all forms of sodium and sugar, as well as wheat, rye, buckwheat, food coloring, preservatives, nitrates, sulfites, hormones, antibiotics, oh my the list goes on.

I always wonder why the folks who conduct these studies do not take this into account. If you are going to study the benefits of a GF/CF diet, it is absolutely critical that you’re not giving these kids cookies which contain other allergens which can still impact behavior. It is unfortunate, that this clip did not go deeper into the impact that gluten has on the gut of children who, in many cases have an over growth of candida, enter colitis, and a leaky gut. . . . . and the direct and specific impact of the intestines trying to break this chemical down in children diagnosed with autism is detrimental to the individuals behavioral, mental and physical health.

Gluten Free may not be the answer for every child, but for those who suffer from this syliac type of disorder that gluten can replicate in children with autism, it is more than beneficial, it’s paramount that this is eliminated from the diet of these children. In order to really look closely at the benefits of a specific diet, the child or children in the study must have all allergens that may cause or trigger a behavior removed from the food and the studies must be extensive to include a wide and random control group.

For more info on this check out sites that may discuss leak gut and autism, candida overgrowth and autism, oxidative stress and autism, benefits of special diets and autism. Let us know your thoughts. . . . . . .

Researchers have found a sharp difference between the beliefs of ordinary people and medical experts about the reason for the increased incidence of autism. Expert consensus is that the rapid increase is a result of changes in diagnostic practice, but many lay people directly or indirectly affected by the disorder believe that the number of cases have increased in absolute terms. Many also believe that the increasing incidence is the result of exposure to new environmental hazards. Recent studies of the University of Exeter and Bristol have published their findings in the journal CHILD. Despite public opinion concrete ANSWERS to the cause of this puzzling disability will inevitably lead to a cure; it is imperative that research into every plausible scientific, bio-medical, and biological cause of autism be fully explored to unfold every possible cure. Tell us what you believe!

The Huffington Post, December 11, 2010 article, http://www.huffingtonpost.com/dr-mark-hyman/autism-research-discovery_b_794967.html gives parents hope for possible causes of Autism. The Journal of the American Medical Association and reseachers of U.C. Davis tells us about mitochondrial dysfunction and oxidative stress in individuals with autism. Could this lead to new methods of treatment and possible reversal of autism? Let us hear your voice. . . . . . .

There is a systemic problem with the way that children and adults with an autism spectrum disability are accessing health insurance in our country. This presents a real problem for them and their families. More often than not, many families are saddled with the financial burden of providing healthcare to these children at exorbitant cost. Under the current system; many of these individuals are found ineligible for health insurance coverage as a person with a disability, based on qualifying events that have nothing to do with their disability or medical needs. There is something profoundly wrong with this result . . . . . .